Medical paper explores health tourism


When the UK’s most renowned medical journal, The Lancet, offers a thoughtful paper on health tourism, it shows that the medical profession takes the business of medical tourism very seriously.

What is fascinating is that Dr Richard Smith of the London School of Hygiene and Tropical Medicine, and colleagues who helped him, have no connection with medical tourism. Unlike others, they are neither trying to promote medical tourism, nor protecting healthcare organisations from a threat to their income, nor promoting a medical tourism service or book.

Much of what is written on medical tourism gives the impression that the vast majority of potential business comes from the US or the UK. As totally unbiased observers, they show that although these are important markets, they are far from being core to worldwide medical tourism.

The paper pointed out: “Social, cultural, and linguistic factors generate a strong regional dimension, with substantial intra-regional movement of patients, especially in bordering countries.”

For example, 70 percent of patients going to Singapore and Malaysia are from their neighbouring Asean member countries, while medical travellers going to Cuba are mainly from the Caribbean and Central America, and those going to Jordan are mostly from Yemen, Bahrain, Sudan, Syria, Libya, Palestine, and Saudi Arabia.

“The diaspora population is also an important source for foreign patients for countries such as India,” The Lancet paper noted. This is a view that contradicts many writings on medical tourism, which do not view citizens living abroad are potential medical travellers. Diaspora is more then just expatriates living outside their own country, it extends to the second, third and subsequent generations.

To those in the medical tourism business, the paper offers little that is new. But the analysis of the business is still interesting. Some of the findings are:

•    Health tourism accounts for an estimated four million patients a year

•    The market is worth US$20 billion to US$40 billion now

•    It could be worth US$100 billion by 2012.

•    Asia is the leader in attracting such patients. Thailand attracts one million a year, with India, Singapore, and Malaysia expected to reach that number by 2012.

•    The demand for services abroad is driven by domestic non-availability, often in specialised and niche or alternative treatment areas.

•    Low labour costs combined with high-quality medical professionals (many of whom are trained in the US or the UK) give many developing countries a huge cost advantage.

The paper’s view is that active assistance from governments is what makes certain countries more successful than others.

“Many countries also engage in active policies, aggressive marketing and targeted initiatives to promote themselves as regional hubs for medical tourism. Governments offer special facilities and incentives for medical tourists, such as investing or helping with investment in multispecialty world-class hospitals; expedited visa procedures, including specific medical visas; integration of healthcare and tourist facilities; and funding higher medical education overseas to strengthen human resources,” it said.

It also illustrated why some hospital groups do better than others.

“Corporate hospital groups in India, such as Apollo Hospitals, Fortis Healthcare, and Wockhardt, have partnered international insurance and tourism companies and hospitals and practitioners abroad. Private healthcare groups in Singapore such as Raffles Hospital and Parkway Group Healthcare, have established marketing offices in China, south Asia, the Middle East, Indochina, and Russia. “

The paper also observed that while medical tourism is only one part of global healthcare, other factors are inextricably entwined within it, ie: the movement of health professionals and services across country boundaries, and the internationalisation of investment in and by hospitals and clinics. So increasingly, it is the hospital going to the patient rather than conventional medical tourism.

The paper’s outsider view noted that while some governments and hospitals are extremely active and professional, those who passively support the business, and somehow expect customers to flock to them, are always going to be disappointed.

One area seen as a constraint for the industry is the lack of portability of national and private health insurance. But they appear to suggest that even if all insurers were to pay for medical tourism, this would only result in a marginal increase in patient numbers travelling overseas. 



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